| NPI | 1689896631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 44364) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD431501) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2017-01-09 |